The use of cyclosporine in dermatology: Part I - 24/04/13

Doi : 10.1016/j.jaad.2010.02.063

Karrie T. Amor, MD ^a, Caitriona Ryan, MBBCh, BAO ^b, Alan Menter, MD ^b,^⁎
^a Department of Dermatology at the University of Texas, Houston, Texas
^b Department of Dermatology, Baylor University Medical Center, Dallas, Texas

Correspondence to: Alan Menter, MD, Department of Dermatology, Baylor Research Institute, 3900 Junius St, Ste 145, Dallas, TX 75246.

Abstract

Cyclosporine is a calcineurin inhibitor that acts selectively on T cells. It has been used in dermatology since 1997 for its US Food and Drug Administration indication of psoriasis and off-label for various other inflammatory skin conditions, including atopic dermatitis, blistering disorders, and connective tissue diseases. In the last decade, many dermatologists have hesitated to use this important drug in their clinical practices because of its toxicity profile. The purpose of this article is to review the mechanism of action of cyclosporine and its current uses and dosing schedules. It is our goal to create a framework in which dermatologists feel comfortable and safe incorporating cyclosporine into their prescribing regimens.

Learning objectives

After completing this learning activity, participants should be able to describe the mechanism of action of cyclosporine, recognize the potential role of cyclosporine in dermatology and the evidence to support this role, and incorporate cyclosporine into his or her prescribing regimens.

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Key words : atopic dermatitis, chronic urticaria, cyclosporine, psoriasis, pyoderma gangrenosum

Plan

Bruce H. Thiers, MD, Editor, has disclosed the following financial relationships: Elsevier- Other/Honoraria, Galderma- Other/Honoraria, Graceways Pharmaceuticals- Consultant/Honoraria. Dirk M. Elston, MD, Deputy Editor, has disclosed the following financial relationships: Intendis- Investigator/No Compensation. Robert T. Brodell, MD, JAAD CME Planner, has disclosed the following financial relationships: 3M/Graceway Pharmaceuticals- Speaker/Honoraria, Allergan- Speaker/Honoraria, Dermik/BenzaClin- Speaker/Honoraria, Dow Pharmaceutical Sciences- Consultant/Honoraria, Galderma Laboratories, LP- Speaker/Honoraria, GlaxoSmithKline- Speaker/Honoraria, Graceway Pharmaceuticals, LLC- Speaker/Honoraria, Medicis- Advisory Board/Honoraria, Novaritis Pharmaceuticals- Speaker/Honoraria, Promius- Advisory Board/Honoraria, Sanofi-Aventis- Speaker/Honoraria. Joseph C. English III, MD, JAAD CME Planner, has disclosed the following financial relationships: Centocor- Investigator/No compensation. James R. Treat, MD, JAAD CME Planner, has disclosed the following financial relationships: Pierre Fabre-Investigator/Grants. Hensin Tsao, MD, JAAD CME Planner, has disclosed the following financial relationships: Genentech- Consultant/Honoraria, Quest Diagnostics- Consultant/Honoraria, SciBASE-Consultant/Honoraria. Matthew Zirwas, MD, JAAD CME Planner, has disclosed the following financial relationships: Astellas Pharmaceuticals- Speaker/Honoraria, Coria Laboratories- Speaker/Honoraria, Consultant/Honoraria, Onset Therapeutics-Consultant/Honoraria. Caitrona Ryan, MBBCh, BAO, Author, has disclosed the following financial relationships: Abbott-Other/Grant, Galderma- Advisory Board/Honoraria. Alan Menter, MD, Author, has disclosed the following financial relationships: Abbott- Advisory Board/Grant, Consultant/Honoraria, Investigator/Honoraria, Speaker/Honoraria, Amgen-Speaker/Honoraria, Advisory Board/Grant, Astellas- Consultant/Grant, Advisory Board/Honoraria, Celgene-Investigator/Grant, Centocor- Advisory Board/Honoraria, Consultant/Grant, Eli Lilly- Investigator/Grant, Galderma-Advisory Board/Honoraria, Speaker/Honoraria, Genentech- Advisory Board/Grant, Novartis- Investigator/Grant, Novo Nordisk- Investigator/Grant, Pfizer- Investigator/Grant, Promius-Investigator/Grant, Stiefel-Investigator/Grant, Syntrix-Investigator/Grant, Warner Chilcott-Advisory Board/Honoraria, Wyeth-Advisory Board/Honoraria, Speaker/Honoraria, Investi-gator/Grant. All other authors, editors, planners, peer reviewers, and staff have no relevant financial relationships.

Reprints not available from the authors.